"In the summer, the Cuban leader bled abundantly in the intestine," El Pais reported. "This adversity led him to the operating table, according to the medical sources. His condition, moreover, was aggravated because the infection spread and caused peritonitis, the inflammation of the membrane that covers the digestive organs."

The recovery from the first operation, in which part of his large intestine was extracted and the colon was connected to the rectum, did not go well. The link broke and he released feces into the abdomen that caused another peritonitis, the report said.

A second operation to clean and drain the infected area also failed, the paper said. He was then hit with inflammation of the bile duct, an illness which has a[n] 80 percent mortality rate, el Pais said. A prothesis made in South Korea was implanted and failed and later was replaced with one made in Spain.

El Pais said that in December, when Garcia Sabrido visited, Castro had an abdominal wound that was leaking more than a pint of fluids a day, causing "'a severe loss of nutrients." The Cuban leader was being fed intravenously, the report said.